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      • KCI등재

        KAL기 추락에 의한 대량재해의 개인식별

        강신몽,이원태,고영창,최상규,김윤희,이홍석,서재관,윤중진,이혜경,최득린,김종열,윤창육,변명식,이장홍 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

        Individual identification is an important part in medicolegal field especially in mass disaster. At July, 27, 1989, KAL KE-803 was crashed on landing at Tripoli International Airport, Liba. The plane was caught in fire and sixty eight Koreans were sacrified. The majority of victims were severely charred and injured. The authors examed all dead bodies and successfully identified all the cases through visual, anthropological, odontological, radiological and pathological methods including fingerprint and blood typing.

      • 고빌리루빈혈증을 동반한 자가면역성 간염 1례

        서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

        자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

      • The Safety and Efficacy of Daclatasvir and Asunaprevir with Chronic HCV Genotype 1 Infection and Hemodialysis

        ( Myeong Jun Song ),( Jung Hyun Kwon ),( Soon Woo Nam ),( Tae Hee Lee ),( Young Woo Kang ),( Ji Woong Jang ),( Seok Hyun Kim ),( Byung Seok Lee5 ),( Sea Hwan Lee ),( Hong Soo Kim ),( Ji Hoon Kim ),( S 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

        Aims: We aimed to evaluate the efficacy and safety of Daclatasvir (DAV) and Asunaprevir (ASV) in patients with chronic hepatitis C virus (HCV) and chronic renal failure (CRF). Methods: 22 chronic hemodialysis patients with HCV infection at 12 medical centers have prospectively enrolled from Feb, 2016 to Feb, 2017 (NCT02580474). Of those, 9 patients who were followed 12 weeks after treatment ended were included. We evaluated the virological responses at each week 4, 12, 24 and the 12-week sustained virologic response (SVR12). The tolerability and safety of patients were also evaluated. Results: Of these 20 patients, there had no resistance-associated variant of NS5A (NS5A RAVs) and 2 patients showed indeterminate NS5A RAVs. 12 patients (54.5%) completed the 24 weeks treatment of DAV and ASV. 6 patients (27.2%) have continued, but 4 patients discontinued study prior to 12 weeks. Overall, all patients (n=9) achieved SVR12. Virologic response at week 4, 12 and 24 showed 94.4% (17/18), 93.3% (14/15), and 100% (12/12) respectively. DCV and ASV were well tolerated among the majority of patients and discontinuation of the treatment due to adverse events (hypertension, bradycardia, leukemia) was occurred in 3 patients. In two patients with indeterminate NS5A RAVs, one achieved SVR12 but the other showed viral breakthrough and discontinued treatment. Conclusions: In this study, DAV and ASV combination therapy for chronic hemodialysis patients with HCV infection achieved high sustained virological response with few adverse events. Close monitoring of safety and tolerability may be necessary when treating chronic hepatitis C patients with CRF receiving DCV and ASV.

      • 충남 서북부지역 여성의 질세포진 검사에 대한 임상적 고찰

        이석민,선우재근,장경택,서수형,김민관,배동한 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

        Pap smear were performed to 30,294 women living in the north-west of Chung-nam. The result are summarized below 1. Positive vaginal cytology was 1.09 percent. 2. 72 percents women in their 30's and 40's experienced vaginal cytology. 3. Vaginal cytology was performed at a decreasing rate as age increases. 4. Positive cytology rate is 2.42% higher than average for elderly women over the age of 65. The present date indicates that pap smear is being widely recognized to be important but they needs to be continued advocacy for pap smear.

      • KCI등재후보

        Bacillus lentimorbus WJ5의 감마선유도 돌연변이체들에서 공통으로 발현되는 방사선 관련 유전자의 microarray 분석

        이영근,장화형,장유신,허재호,형석원,정혜영 한국환경생물학회 2004 환경생물 : 환경생물학회지 Vol.22 No.3

        본 연구에서는 감마선으로 유도된 돌연변이체들에서 공통으로 발현되는 방사선 관련 유전자들의 발현을 연구하기 위하여, B. lentimorbus WJ5의 방사선 유도 돌연변이체에서 발현되는 유전자를 DNA microarray로 동시에 탐색하였다. DNA microarray는 B. lentimorbus WJ5 genome을 무작위로 절단하여 2,000단편으로 구성하였으며, 감마선 (^(60)Co)으로 유도된 7돌연변이체의 발현을 정량적으로 관찰하였다. 클러스터 분석결과 발현된 408 유전자 중 27개가 감마선 유도 돌연변이체 모두에서 유의하게 발현이 증가되었다. 특히, 복구(mutL, mutM)에너지 대사 (acsA, sdhB, p하, yhjB, citB), protease(npr), 산화자극에 대한 환원 (HMM)관련 유전자들이 동시에 증가되었다. 이는 감마선 유도 돌연변이체들에서 자발적인 직/간접 복구 관련 유전자의 발현 증가는 방사선 노출 직후 보이는 stress response와는 다른 현상임을 나타내는 것으로 생각된다. To study the radiation related gene expression in mutants of Bacillus lentimorbus WJ5 induced by gamm radiation, the simultaneous gene expression was analyzed by DNA microarray. We constructed DNA chips including two thousand randomly digested genome spots of B. lentimorbus WJ5 and compared its quantitative aspect with seven mutants induced by gamma radiation (^(60)Co). From the cluster analysis of gene expression pattern, totally 408 genes were expressed and 27 genes were significantly upregulated by the gamma radiation in all mutants. Especially, genes involved in repair (mutL, mutM), energy metabolism (acsA, sdhB, pgk, yhjB, citB), protease (npr), and reduction response to oxidative stress (HMM) were simultaneously upregulated. It seems that the induction of the direct and/or indirect repair related genes in mutants induced by gamma radiation could be remarkably different from the adaptive responses against acute exposure to radiation.

      • KCI등재

        항파상풍 톡소이드 주사후 항파상풍 항체 역가

        이한식,하영록,구홍두,장석준,심호식,김승환,이정운 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

        Objective : Tetanus decreased in prevalence since the systemic vaccination began in 1940s. Despite of the improvement in treatment like critical care with ventilatior or antibiotics, the mortality rate resides around 45%. Currently the tetanus prevention protocol recommends immunization in infancy and boosters every tenth years. Thereafter the immunization with toxoid only or toxoid plus immunoglobulin injections is recommended according to the type of injury. In most of ED in Korea, only tetanus immunoglobulin is given without any basis. Previously we proved the effect that passive immunization with the immunoglubulin 250 IU last long for only a month. At this time we measured the effect of the active immunization with toxoid and its effect was compared to the effect of the tetanus immunoglobulin to find out the logical tetanus prevention after an injury. Method: 20 healthy adult volunteers were injected with tetanus toxoid and their anti-tetanus antibody titers measured before the injection, 1 week and 4 weeks after the inection. No volunteers have taken any medication for chronic illness(e.g. hepatits, tuberculosis) or had an tetanus immunization or booster in the last 6 months. Antibody titers were measured by IMMUNOZYM??-TETANUS and t-test was performed on the results, Results: 1. Total 20 volunteers(12 males and 8 females) were participated. 2. Subjects` ages were 21 to 44 years old and there were no relevance to the antibody titer. 3. The antibody titers of before the anti-tetanus toxoid injection and 1 week, 4 weeks after the injection revealed significant difference and the antibody titers of the first and the forth week after the injection also showed a significant difference. Conclusion: Currently in Korea, the tetenus immunoglobulin 250 IU given alone as tetanus prevention was injected, but it did not elevate the anti-tetanus antibody titer for 4 weeks where as tetanus toxoid injected intramuscularly did significantly. Therefore, tetanus toxoid should be given on the dirty injuries with additional tetanus immunoglobulin injection to accomplish the correct method of tetanus, tetanus toxoid prevention.

      • Linear motor의 2次 導體板의 速度變化에 따른 諸特性에 관한 硏究

        張錫明,李殷雄 충남대학교 공업교육연구소 1978 論文集 Vol.1 No.2

        Linear motors, for several years the subject of much speculation, have at last reached the stage where their practical application to high speed transport systems and the other many industrial filds is within sights. However, the essential difference between Linear induction motors and ordinary induction motors is the fact that the air gap is open in the former, while it is closed in the latter. In this study, the characteristic equation of a double sided short stator Linear induction motor excited by equivalent current sheet having a linear current density was derived using Maxwell's electromagnetic field thory with its entry, and exit, end effects taken in to consideration. According to the treatment of several physical phenomena in the air gap i.e. the magnetic flux density distributions thrustforce, forward travelling wave with decay, the fundamental data in this study are made reference to improve the characteristics of Linear induction motors, effectual electric-thrustforce energy conversion devices.

      • 외상후 발작의 위험인자에 대한 조사

        이재학,배학근,윤석만,도재원,이경석,윤일규,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

        Risk Factors for Posttraumatic Seizure The authors evaluate the risk factors for posttraumatic seizures. this prospective study was performed in a series of 470 head injured patient from January 1996 to Decomber 1998. The patients who were dead within 1 week of injury or children from 3 years old and under were excluded. There were 358 male and 112 female with a mean age of 35.2±22.8 years (range, 4-88 years). The results were as follows : 1). Of the 470 patients, pasttraumatic seizure occurred in 48 patients(10.2%): early seizure in 28(6%) and late seizure in 20 patients(4.2%). 2). The clinical risk factors for posttraumatic seizure were poor consciousness at admission, presence of brainstem herniation signs, poor GCS score, and posttraumatic amnesia more than 24 hours after trauma(p<0.001). 3). The radiological risk factors for posttraumatic seizure were subdural hematoma(p<0.001), intracerebral hematoma (p<0.02), mutiple intracranial CT lesions(p<0.001), or delayed lesions on follow-up CT scans(p<0.001). the incidence of seizure increased according to the severity of diffuse brain lesion(p<0.001), and the seizure rate in mass lesion was higher than that in diffuse lesion(p<0.001). 5). Hypoxia and coagulopathy had a statistically significant influence on posttraumatic seizure(p<0.05). Hypoxia had a infuence on occurrence of late seizure(p<0.05). 6). The incidence of posttraumatic seizure signiticantly increased in surgical group compared with coservative group(p<0.001) and significantly increased in patient who underwent decompressive craniectomy compared with those who underwent craniotomy(p<0.001) 7). Preventive administration of antiepileptic drugs decreased the incidence of early seizure, but did not affect on the reduction of late seizure. 8). Multivariate logistic regression analysis showed the subdural hematoma, GCS score, delayed lesion, and intracerebral hematoma in order of importance for seizure risk. in conclusion, the risk factors affecting on the occurrence of seizure were clinical status at admission, CT lesions, and severity of diffuse brain inJury. Considering that hypoxia affected on the late seizure, it is necessary to detect and treat it immediately after trauma. In addition, the patients who underwent decompressive craniectomy should be carefully followed to evaluate the risk of late seizure. Even though preventive administration of antiepileptic drugs had a tendency to decrease the incidence of early seizure, it is unclear whether administration of antiepileptic drugs can reduce the incidence of posttraumatic seizures. Prospective study will be needed in the selected patients.

      • KCI등재

        응급의료센터 과밀화 해소를 위한 환자 전원

        이경룡,구홍두,박인철,김승환,장석준,심호식 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

        To reduce the degree of overcrowding in level Ⅲ emergency care centers, authors have conducted a prospective study of patient who were transferred to level Ⅰ or Ⅲemergency center based on the non-emergent patient guideline currently used at the severance Hospital, level Ⅲ emergency center, during the period of 65 days from Jan. 1st 1995 to Mar. 6th 1995. Followings are guideline for non-emergent patient described by the Korean government low: 1) systolic blood pressure greater than 80/100 of normal. 2) respiration rate between 10 to 24 per minute. 3) pulse rate between 60 to 100 per minute. 4) body temperature between 36 to 37.5℃ by rectal. 5) relatively alert mental status. 6) patient not requiring emergency operation at the time of examination. The results were as follows: 1. Among the total 5,301 patients, 464 patients ranged from age of 1 to 82 years old were transferred to level Ⅰor Ⅱ emergency center after simple treatment. 2. Among the 464 patients, 276 patients were treated in expected hospital with medical problems in 101 (36.6%) patients, and 175 (63.4%) patients had surgical problems. 3. Among the 276 patients, 122 (44.2%) patients were admitted, 145 (52.9%) patients were discharged from the emergency room after adequate treatment. 4. Among the transferred patients, simple laceration (33.0%) were most common, acute gastroenteritis (12.0%), and simple contusion (10.5%) were followed. These results suggest that about 10% of patients visiting level Ⅲ emergency care center, can be safely transferred to nearest level Ⅰor Ⅱ emergency centers on the bases of non-emergent patient guideline described by Emergency Medical Service law. These guideline, if put into proper use, can reduce the degree of overcrowding problems in level Ⅲ emergency care center through out the country.

      • 상용 소프트웨어 GENESIS를 이용한 강도 설계 민감도해석에 관한 연구

        이선봉,장득열,조석수 三陟大學校 2001 論文集 Vol.34 No.1

        Mechanical component under fatique loading has striation with constant width, and SEM can estimate fracture type and loading condition. SEM has benefit to fatigue fracture analysis but striation can be observed according to the kind of material and range of crack growth rate, and can't. In this case, it needs AFM that can measure 3-dimensional surface profile with resolution of atomic size. In this study, to find fracture reason of torsion-mounted blade in nuclear plant, we estimate the relation between stress intensity factor range and surface roughness in 12% Cr steel by AFM and predict in-service load condition. Finite element analysis is performed on torsion-mounted blade

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